The proper folding of a surgical gown is a foundational procedure in infection control, directly supporting the principle of asepsis within a medical setting. This meticulous process ensures the gown remains protected from environmental contamination before sterilization, typically through steam autoclaving. The specific folding pattern allows the surgical team to don the gown without touching the sterile exterior surface when it is opened for use. A standardized fold facilitates a swift, error-free presentation, which is paramount for maintaining a sterile field and supporting operating room efficiency.
Preparing the Gown for Sterilization
Preparation begins with a thorough inspection of the gown, which must be completely clean and dry. Any signs of damage, such as tears, holes, or frayed seams, require the gown to be removed, as compromised material cannot maintain a barrier against pathogens. The workspace must be a designated, sanitized area, free from dust or clutter to prevent accidental contamination during handling.
The individual folding the gown should wear appropriate personal protective equipment, including a hair cover and mask, to minimize the risk of introducing foreign particulates. The gown is laid flat on the clean surface, typically with the inside facing upward. This orientation ensures that the exterior surface, which forms the sterile barrier, is the last surface to be covered and protected by the subsequent folds.
The Step-by-Step Aseptic Folding Method
The initial step in the aseptic folding method is to create a long, narrow rectangle from the gown’s body. This is accomplished by bringing the sides of the gown inward toward the center line, often in thirds, ensuring the shoulder seams and armholes are neatly aligned. Precision during this initial fold is important because misalignment can create bulk and interfere with the final presentation for donning.
Once the gown is vertically aligned, the sleeves must be managed to prevent them from dangling or exposing non-sterile surfaces during opening. Each sleeve is folded inward along the center line, ensuring the cuffs are easily accessible but remain tucked within the body of the gown. This placement prevents the sleeves from whipping out during the unfolding process, which could inadvertently contaminate the sterile field.
The core of the aseptic technique is the accordion or fan fold, which is started by creating small, uniform pleats moving down the length of the gown. Beginning at the collar, a short section is folded over, then a section of equal size is folded back, creating a continuous zig-zag pattern. This folding continues down to the hem, converting the long rectangle into a compact, pleated bundle.
The accordion fold allows the person donning the gown to grasp only the neck and shoulder area. When the folded pack is opened, the gown gently falls open without the wearer having to touch the sterile outside surface. This ensures the non-sterile inner part of the gown is manipulated first, while the sterile exterior remains untouched until fully deployed.
The final step involves securing the pleated bundle so it maintains its shape for wrapping and sterilization. Many reusable gowns have attached fabric ties used to secure the folded package. These ties are wrapped snugly around the pleated gown to keep the accordion folds from expanding prematurely, allowing the gown to present itself correctly when the outer sterile wrap is removed.
Securing and Finalizing the Pack
After the gown has been folded and secured with its internal ties, it is ready to be enclosed in a sterile barrier system. This involves placing the folded gown onto the center of a specialized sterile wrap, often made of two layers of non-woven material or cloth. The use of a double-wrap technique is standard practice, as the layers establish a tortuous path for microorganisms, reducing the risk of contamination during handling and storage.
Before the first layer of wrap is sealed, a chemical indicator is placed inside the pack, typically in the geometric center of the gown bundle. This internal indicator strip changes color only after exposure to the specific conditions of the sterilization cycle, providing proof that the steam or gas reached the deepest part of the pack. The wrap is then folded using the envelope method, creating a tab that allows sterile field personnel to open the package without reaching over the contents.
The second, outer layer of wrap is applied similarly, and the package is sealed with indicator tape. This tape serves two functions: securing the wrap and providing an external check of the sterilization process. The final step is to apply a label clearly indicating the contents, the date of sterilization, and the initials of the person who prepared the pack. Finished packs must be stored in a cool, dry area, as moisture or excessive pressure can compromise the integrity of the sterile barrier.